Testing for Fibromyalgia
You're constantly in pain; you have extreme fatigue and suffer from chronic headaches as well as irritable bowel syndrome. But is it really fibromyalgia?
The difficulty with diagnosing fibromyalgia lies in the fact that, in most cases, laboratory testing appears normal and that many of the symptoms mimic those of other disorders. A definite diagnosis of fibromyalgia syndrome should only be made when no other medical disease can explain the symptoms. This is to say, fibromyalgia is a diagnosis of exclusion.
A proper history and physical exam coupled with blood work and/or x-rays may be done to rule out:
- Hormonal imbalance
- Muscle disease
- Bone disease
- Nerve disease
- Joint disease
- Rheumatoid arthritis
- Hypothyroidism (including primary hypothyroidism, secondary hypothyroidism, Hashimoto’s thyroiditis, iodine deficiency goiter, and genetic thyroid enzyme defects). Thyroid-stimulating hormone levels should be checked routinely because this condition can mimic many of the symptoms of fibromyalgia
- Polymyalgia rheumatica
Electrical nerve and muscle testing, known as electromyography (EMG) or nerve conduction velocity (NCV), may also be done to check the muscles and nerves.
Fibromyalgia Tender Points
Upon physical examination, the fibromyalgia patient will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria, patients must have:
Widespread pain in all four quadrants of their body for a minimum of three months. Pain is considered widespread when all of the following are present:
- Pain in the left side of the body
- Pain in the right side of the body
- Pain above the waist
- Pain below the waist
- Pain in the neck, front of your chest, mid-back, or low back